Introduction: Influenza 1918

Early in the morning of March 11, 1918, a young private reported to the Army hospital at Fort Riley, Kansas, complaining of fever, sore throat, and headache. Then, another sick soldier appeared, then another and another. By noon, the hospital had more than one hundred cases; in a week, there were five hundred. Forty-eight soldiers died at Fort Riley that spring. No one knew why.

Influenza 1918 is the story of the worst epidemic the United States has ever known. Before it was over, the flu would kill more than 600,000 Americans — more than all the combat deaths of this century combined.

“For the survivors we spoke to,” says producer Robert Kenner, “the memory is one of horror and fear — which may explain why many Americans were willing to let those few terrible months fade into obscurity. Schoolchildren know more about the Black Plague from centuries ago than they do about this episode in our recent history.”

America in 1918 was a nation at war. Draft call-ups, bond drives, troop shipments were all in high gear when the flu epidemic appeared. American soldiers from Fort Riley carried the disease to the trenches of Europe, where it mutated into a killer virus. The disease would later be dubbed, inaccurately, Spanish influenza. Spain had suffered from a devastating outbreak of influenza in May and June of 1918. The country, being a non-combatant in the war, did not censor news of the epidemic that was cutting through its population and was therefore incorrectly identified as its place of origin.

Meanwhile, returning American troops were bringing the flu back home. First hundreds, then thousands of soldiers were lining up outside infirmaries and hospitals at army bases across the country, falling ill with a swiftness that defied belief. Dr. Victor Vaughan, Surgeon General of the Army, was stunned by what he saw at Camp Devens just outside of Boston. “Every bed is full, yet others crowd in,” he wrote. “The faces wear a bluish cast; a cough brings up the blood-stained sputum. In the morning, the dead bodies are stacked about the morgue like cordwood.” On the day Vaughan arrived, 63 men died at Camp Devens.

In September, the disease spread to the civilian population. It moved swiftly down the eastern seaboard to New York, Philadelphia, and beyond. Anna Milani remembers sitting on her front step one day: “Diagonally across from us a fifteen-year-old girl was just buried. Toward evening, we heard a lot of screaming going on. In that same house, a little eighteen-month-old baby passed away.” That month, 12,000 Americans died of influenza.

It was a flu unlike any other. People could be healthy in the morning and dead by nightfall. Others died more slowly, suffocating from the buildup of liquid in their lungs.

Thanks to advances in microbiology, researchers had developed vaccines for many bacterial diseases: smallpox, anthrax, rabies, diphtheria, meningitis. But doctors were helpless to stop the influenza of 1918. Though they knew the disease spread through the air, medical researchers were unable to see the tiny virus through microscopes of the time and incorrectly identified its cause as a bacteria. Vaccines they developed didn’t work; the virus was too small, too elusive.

With medical science powerless, many people turned to folk remedies: garlic, camphor balls, kerosene on sugar, boneset tea. Public health officials distributed masks, closed schools; laws forbade spitting on the streets. Nothing worked. The war was at cross-purposes with the epidemic: the war effort brought people into the streets for rallies and bond drives. They coughed on each other, infected each other. Soldiers traveled in crowded transport ships. The disease spread everywhere.

October saw the epidemic’s full horror: more than 195,000 people died in America alone. There was a nationwide shortage of caskets. In Philadelphia, the dead were left in gutters and stacked in caskets on front porches. Trucks drove the city streets, picking up the caskets and corpses. People hid indoors, afraid to interact with their friends and neighbors.

“Everybody was living in deadly fear because it was so quick, so sudden, and so terrifying,” says William Sardo, the son of a funeral director whose home was stacked with caskets of flu victims. “It destroyed the intimacy that existed among people.”

Surgeon General Vaughan reached a frightening conclusion. “If the epidemic continues its mathematical rate of acceleration,” he announced, “civilization could easily disappear from the face of the earth within a few weeks.”

Then, just as suddenly as it struck, the calamitous disease abruptly began to vanish. By mid-November, the numbers of dead were plunging. “In light of our knowledge of influenza,” says Dr. Shirley Fannin, a Los Angeles County public health official, “we do understand that it probably ran out of fuel. It ran out of people who were susceptible and could be infected.”

Over time, World War I and painful memories associated with the epidemic allowed many people to forget about it. But for the survivors, the influenza of 1918 changed their lives forever.